台湾医界使用止痛剂十年的大趋势-孙维仁

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My presentation at 2009年中华医学会全国麻醉学术年会

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台湾医界使用止痛剂十年的大趋势-孙维仁

  1. 1. 1997 2007
  2. 2. 3
  3. 3. 80+ 61-80 <20 21-60
  4. 4. 6
  5. 5. N= 1,172,115 23 = (national survey) (population-based) (Cohort analysis) ... (longitudinal study)
  6. 6. A school of fishes is not yours 8
  7. 7. it depends on how you are fishing! 8
  8. 8. Defined Daily Dose (DDD) Opioids DDD morphine= 30 mg pethidine=100 mg codeine=400 mg 9
  9. 9. 300 pethidine codeine 225 morphine 1987-2002 150 75 0 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
  10. 10. 1,891 Italy 121 1,892 total DDD Taiwan 168 morphine DDD 4,550 Germany 574 1994-1998 27,942 Switzerland 1,763 27,748 UK 2,569 29,701 Denmark 6,993 39,316 Ireland 2,454 0 8,000 16,000 24,000 32,000 40,000 defined daily dose/million
  11. 11. COX2 NSAID Acetaminophen
  12. 12. I Pethidine Tramadol Morphine Fentanyl NSAID ketorolac
  13. 13. III NSAID ketorolac non-ketorolac 45
  14. 14. II opioid NSAID NSAID opioid ketorolac non- ketorolac
  15. 15. IV 2003 2004
  16. 16. 1997 2007 36
  17. 17. Paradox I
  18. 18. Paradox I
  19. 19. Paradox II
  20. 20. Paradox II
  21. 21. 41

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